| NPI | 1588898217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR ALDO LUNA Pediatric Dentist 703-462-8412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0401410972) |
| Enumeration Date | 2009-05-09 |
| Last Update Date | 2009-05-09 |